| News & Announcements | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Medicare Advantage Members (Updated December 15, 2022) | | | | | | 12/15/2022 | | | Testing for SARS-CoV-2 (Coronavirus Disease 2019 (COVID-19)) for Independence Medicare Advantage Members (Updated December 15, 2022) | |
| News & Announcements | 01/01/2023 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | | | | | | 12/30/2022 | | | 01/01/2023 CPT & HCPCS Quarterly Code Update Coverage Determinations for Medicare Advantage Products | |
| Notifications | eviCore Lab Management | MA06.034h | 12/2/2022 11:00 AM | 1/1/2023 | | | 12/2/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | eviCore Lab Management | |
| Notifications | Neuromuscular Electrical Stimulators (NMES) and Functional Electrical Stimulators (FES) | MA05.058c | 12/2/2022 1:00 PM | 1/2/2023 | | | 12/2/2022 | Coverage and/or Reimbursement Position;Medical Coding | | Neuromuscular Electrical Stimulators (NMES) and Functional Electrical Stimulators (FES) | |
| Notifications | Transcranial Magnetic Stimulation (TMS) | MA07.035d | 12/5/2022 5:00 PM | 1/1/2023 | | | 12/5/2022 | Medical Necessity Criteria | | Transcranial Magnetic Stimulation (TMS) | |
| Notifications | Implantable and External Infusion Pumps | MA05.053k | 12/19/2022 2:00 PM | 1/18/2023 | | | 12/19/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Implantable and External Infusion Pumps | |
| New Policies | Rapid Whole Exome Sequencing (rWES) and Rapid Whole Genome Sequencing (rWGS) for Diagnosis of Genetic Disorders | MA06.035 | | 1/1/2023 | | | 12/15/2022 | This is a New Policy. | | Rapid Whole Exome Sequencing (rWES) and Rapid Whole Genome Sequencing (rWGS) for Diagnosis of Genetic Disorders | |
| New Policies | Spesolimab--sbzo (Spevigo®) | MA08.155 | | 12/19/2022 | | | 12/19/2022 | This is a New Policy. | | Spesolimab--sbzo (Spevigo®) | |
| New Policies | Psychological Testing | MA14.002 | 11/1/2022 9:00 AM | 1/1/2023 | | | 12/30/2022 | This is a New Policy. | | Psychological Testing | |
| New Policies | Electroconvulsive Therapy (ECT) | MA14.001 | 11/1/2022 12:00 PM | 1/1/2023 | | | 12/30/2022 | This is a New Policy. | | Electroconvulsive Therapy (ECT) | |
| Updated Policies | Ostomy Supplies | MA05.014d | 11/4/2022 9:00 AM | 12/5/2022 | | | 12/5/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Ostomy Supplies | |
| Updated Policies | Musculoskeletal Services | MA00.047g | | | | | 12/5/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria | | Musculoskeletal Services | |
| Updated Policies | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | MA00.002i | | 12/5/2022 | | | 12/5/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | |
| Updated Policies | High-Technology Radiology Services | MA09.002x | | 11/6/2022 | | | 12/5/2022 | General Description, Guidelines, or Informational Update | | High-Technology Radiology Services | |
| Updated Policies | Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound | MA11.113f | | 11/6/2022 | | | 12/5/2022 | General Description, Guidelines, or Informational Update | | Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound | |
| Updated Policies | X-rays Associated with Fractures in the Office Setting | MA00.031f | | 12/5/2022 | | | 12/5/2022 | Coverage and/or Reimbursement Position | | X-rays Associated with Fractures in the Office Setting | |
| Updated Policies | Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies | MA05.006h | | 12/5/2022 | | | 12/5/2022 | Medical Coding;General Description, Guidelines, or Informational Update | | Transcutaneous Electrical Nerve Stimulators (TENS) and Associated Supplies | |
| Updated Policies | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | MA00.010aj | | 12/5/2022 | | | 12/5/2022 | Coverage and/or Reimbursement Position | | PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services | |
| Updated Policies | Never Events and Preventable Serious Adverse Events | MA00.039e | | 12/5/2022 | | | 12/5/2022 | General Description, Guidelines, or Informational Update | | Never Events and Preventable Serious Adverse Events | |
| Updated Policies | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | MA07.026j | | 12/9/2022 | | | 12/9/2022 | General Description, Guidelines, or Informational Update | | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | |
| Updated Policies | Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | MA08.082i | 11/18/2022 9:00 AM | 12/19/2022 | | | 12/19/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Eflapegrastim-xnst (Rolvedon™), Pegfilgrastim (Neulasta®) and Related Biosimilars | |
| Updated Policies | In Vitro Allergy Testing | MA06.002c | 11/18/2022 10:00 AM | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | In Vitro Allergy Testing | |
| Updated Policies | Speech and Non-Speech Generating Devices | MA05.003e | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Speech and Non-Speech Generating Devices | |
| Updated Policies | Tafasitamab-cxix (Monjuvi®) | MA08.138a | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Tafasitamab-cxix (Monjuvi®) | |
| Updated Policies | Ado-Trastuzumab Emtansine (Kadcyla®) | MA08.066f | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Ado-Trastuzumab Emtansine (Kadcyla®) | |
| Updated Policies | Reduction Mammoplasty | MA11.069d | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Reduction Mammoplasty | |
| Updated Policies | Surgery for Gynecomastia | MA11.110a | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Surgery for Gynecomastia | |
| Updated Policies | Scar Revision | MA11.078c | | 12/19/2022 | | | 12/19/2022 | Coverage and/or Reimbursement Position;General Description, Guidelines, or Informational Update | | Scar Revision | |
| Updated Policies | Reimbursement for Radiopharmaceutical Agents for Professional Providers | MA09.009r | | 12/19/2022 | | | 12/19/2022 | Medical Coding | | Reimbursement for Radiopharmaceutical Agents for Professional Providers | |
| Updated Policies | Loncastuximab tesirine-lpyl (Zynlonta®) | MA08.139b | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Loncastuximab tesirine-lpyl (Zynlonta®) | |
| Updated Policies | Polatuzumab vedotin-piiq (Polivy®) | MA08.108d | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Polatuzumab vedotin-piiq (Polivy®) | |
| Updated Policies | Cemiplimab-rwlc (Libtayo®) | MA08.124b | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Cemiplimab-rwlc (Libtayo®) | |
| Updated Policies | Enfortumab vedotin-ejfv (Padcev®) | MA08.113d | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Enfortumab vedotin-ejfv (Padcev®) | |
| Updated Policies | Avelumab (Bavencio®) | MA08.122b | | 12/19/2022 | | | 12/19/2022 | Medical Necessity Criteria | | Avelumab (Bavencio®) | |
| Updated Policies | Chemical Peels | MA11.103b | 9/26/2022 2:00 PM | 12/26/2022 | | | 12/26/2022 | Coverage and/or Reimbursement Position | | Chemical Peels | |
| Updated Policies | Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists and Related Biosimilars | MA08.073j | | 1/1/2023 | | | 12/30/2022 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Intravitreal Injection of Vascular Endothelial Growth Factor (VEGF) Antagonists and Related Biosimilars | |
| Updated Policies | Gonadotropin-Releasing Hormone Agonist (Camcevi™, Eligard®, Fensolvi®, Lupron Depot®) | MA08.083h | | 1/31/2022 | | | 12/30/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Gonadotropin-Releasing Hormone Agonist (Camcevi™, Eligard®, Fensolvi®, Lupron Depot®) | |
| Updated Policies | Home-Use Light Box for the Treatment of Seasonal Affective Disorder (SAD) | MA05.022a | 11/1/2022 10:00 AM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Home-Use Light Box for the Treatment of Seasonal Affective Disorder (SAD) | |
| Updated Policies | Cranial Electrotherapy Stimulation | MA05.066c | 11/1/2022 10:00 AM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Cranial Electrotherapy Stimulation | |
| Updated Policies | Durvalumab (Imfinzi®) | MA08.123b | | 1/2/2023 | | | 12/30/2022 | Coverage and/or Reimbursement Position | | Durvalumab (Imfinzi®) | |
| Updated Policies | Intravenous Infliximab and Related Biosimilars | MA08.019l | | 1/2/2023 | | | 12/30/2022 | Medical Necessity Criteria;Medical Coding | | Intravenous Infliximab and Related Biosimilars | |
| Updated Policies | Acute Care Facility Inpatient Transfers | MA12.003b | 11/1/2022 11:00 AM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Acute Care Facility Inpatient Transfers | |
| Updated Policies | Capsule Endoscopy | MA07.022e | | 1/1/2023 | | | 12/30/2022 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Capsule Endoscopy | |
| Updated Policies | Pertuzumab (Perjeta®) | MA08.063f | | 1/2/2023 | | | 12/30/2022 | Medical Necessity Criteria | | Pertuzumab (Perjeta®) | |
| Updated Policies | eviCore Lab Management | MA06.034h | 12/2/2022 11:00 AM | 1/1/2023 | | | 12/30/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | eviCore Lab Management | |
| Updated Policies | Transcranial Magnetic Stimulation (TMS) | MA07.035d | 12/5/2022 5:00 PM | 1/1/2023 | | | 12/30/2022 | Medical Necessity Criteria | | Transcranial Magnetic Stimulation (TMS) | |
| Updated Policies | Vagus Nerve Stimulation (VNS) | MA11.019h | 11/1/2022 12:00 PM | 1/1/2023 | | | 12/30/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | 12/30/2022 | Vagus Nerve Stimulation (VNS) | |
| Updated Policies | Deep Brain Stimulation (DBS) | MA11.005e | 11/1/2022 12:00 PM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Deep Brain Stimulation (DBS) | |
| Updated Policies | Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD) | MA11.055f | | 1/2/2023 | | | 12/30/2022 | Coverage and/or Reimbursement Position;Medical Necessity Criteria;General Description, Guidelines, or Informational Update | | Procedures for the Treatment of Gastroesophageal Reflux Disease (GERD) | |
| Updated Policies | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | MA11.015s | | 1/1/2023 | | | 12/30/2022 | Medical Necessity Criteria;Medical Coding;General Description, Guidelines, or Informational Update | | Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds | |
| Updated Policies | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | MA06.025p | 11/1/2022 2:00 PM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Presumptive and Definitive Drug Testing in Substance Abuse and Pain Management Treatments | |
| Updated Policies | Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, and Antiepileptics | MA06.029a | 11/1/2022 2:00 PM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Therapeutic Drug Monitoring for Antidepressants, Antipsychotics, and Antiepileptics | |
| Updated Policies | Preventive Care Services | MA00.003u | | 1/1/2023 | | | 12/30/2022 | Medical Necessity Criteria | | Preventive Care Services | |
| Updated Policies | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | MA08.137a | 11/1/2022 9:00 AM | 1/1/2023 | | | 12/30/2022 | General Description, Guidelines, or Informational Update | | Intravenous Ketamine (Ketalar®) and Intranasal Esketamine (Spravato®) | |
| Updated Policies | Cetuximab (Erbitux®) | MA08.031f | | 1/2/2023 | | | 12/30/2022 | Medical Necessity Criteria | | Cetuximab (Erbitux®) | |
| Coding Update | Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing | MA06.032a | | 10/1/2022 | | | 12/7/2022 | | | Cobalamin (Vitamin B12), Folic Acid, and Homocysteine Testing | |
| Coding Update | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | MA07.026k | | 1/1/2023 | | | 12/30/2022 | | | Ambulatory Electrocardiography (AECG) Monitoring and Mobile Cardiac Outpatient Telemetry (MCOT) Monitoring | |
| Coding Update | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | MA00.002j | | 1/1/2023 | | | 12/30/2022 | | | Continuous Glucose Monitors and Home Blood Glucose Monitors and Supplies | |
| Coding Update | Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic) | MA07.023h | | 1/1/2023 | | | 12/30/2022 | | | Upper Gastrointestinal Endoscopy (Diagnostic and Therapeutic) | |
| Coding Update | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | MA11.056g | | 1/1/2023 | | | 12/30/2022 | | | Percutaneous Transluminal Angioplasty (PTA) Concurrent with or without Stenting and Extracranial- Intracranial (EC-IC) Arterial Bypass Surgery | |
| Coding Update | Artificial Intervertebral Lumbar Disc Insertion | MA11.114b | | 1/1/2023 | | | 12/30/2022 | | | Artificial Intervertebral Lumbar Disc Insertion | |
| Coding Update | Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound | MA11.113g | | 1/1/2023 | | | 12/30/2022 | | | Percutaneous Coronary Intervention, Coronary Angiography and Arterial Ultrasound | |
| Coding Update | Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®) | MA08.091e | | 1/1/2023 | | | 12/30/2022 | | | Aprepitant (Cinvanti™), Fosaprepitant Dimeglumine (Emend®), Granisetron (Sustol®), and Rolapitant (Varubi®) | |
| Coding Update | Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma | MA11.105j | | 1/1/2023 | | | 12/30/2022 | | | Aqueous Shunts, Microstents, Viscocanalostomy, and Canaloplasty for the Treatment of Glaucoma | |
| Coding Update | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | MA11.099c | | 1/1/2023 | | | 12/30/2022 | | | Dermabrasion for Rhinophyma, Septoplasty, Rhinoplasty, and Septorhinoplasty | |
| Coding Update | Fecal Microbiota Transplantation (FMT) | MA07.006c | | 1/1/2023 | | | 12/30/2022 | | | Fecal Microbiota Transplantation (FMT) | |
| Coding Update | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | MA08.072k | | 1/1/2023 | | | 12/30/2022 | | | Bevacizumab (Avastin®) and Related Biosimilars For Oncologic Use | |
| Coding Update | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | MA00.030aa | | 1/1/2023 | | | 12/30/2022 | | | Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products | |
| Coding Update | Risankizumab-rzaa (Skyrizi®) for Intravenous Use | MA08.153a | | 1/1/2023 | | | 12/30/2022 | | | Risankizumab-rzaa (Skyrizi®) for Intravenous Use | |
| Coding Update | Bortezomib (Bortezomib for Injection, Velcade®) | MA08.037i | | 1/1/2023 | | | 12/30/2022 | | | Bortezomib (Bortezomib for Injection, Velcade®) | |
